Measurement of community reintegration in sample of severely wounded servicemembers

The Community Reintegration of Servicemembers (CRIS) is a new measure of community reintegration. The purpose of this study was to test the CRIS with seriously injured combat veterans. Subjects were 68 patients at the Center for the Intrepid. Each patient completed three CRIS subscales, the 36-Item Short Form Health Survey for Veterans (SF-36V), the Quality of Life Scale (QOLS), and two Craig Handicap Assessment and Reporting Technique subscales at visit 1 and the 3-month follow-up. Of the patients, 11 also completed the measures within 2 weeks of visit 1. We abstracted diagnoses and activities of daily living from the medical record. We evaluated test-retest reliability using intraclass correlation coefficients (ICCs). We evaluated concurrent validity with Pearson product moment correlations. We used multivariate analyses of variance to compare scores for subjects with and without posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and depression. Responsiveness analyses evaluated floor and ceiling effects, percent achieving minimal detectable change (MDC), effect size (ES), and the standardized response mean (SRM). CRIS subscale ICCs were 0.90 to 0.91. All subscales were moderately or strongly correlated with QOLS and SF-36V subscales. CRIS subscale scores were lower in PTSD and TBI groups (p < 0.05). CRIS Extent of Participation and Satisfaction with Participation subscales were lower for subjects with depression (p < 0.05). Of the sample, 17.4% to 23.2% had change greater than MDC. The ES ranged from 0.227 to 0.273 (SRM = 0.277-0.370), showing a small effect between visit 1 and the 3-month follow-up. Results suggest that the CRIS is a psychometrically sound choice for community reintegration measurement in severely wounded servicemembers.